1. Field of the Invention
The present invention relates to an intracoelomic suturing and ligating method for use in performing a prostatectomy with a manipulator having an operating unit to be gripped by hand, a connector extending from the operating unit, and a working unit mounted on a distal end of the connector, which is angularly movable in response to operation of the operating unit.
2. Description of the Related Art
In endoscopic surgery (also called laparoscopic surgery), it is customary to form a plurality of incisions in the body surface of the patient, insert trocars (tubular instruments) into the respective incisions as forceps instrument passage ports, and introduce the tip ends of forceps instruments having shafts through the respective trocars and into the body cavity in order to perform a surgical operation on the affected part of the body. Working units such as a gripper for gripping living tissue, scissors, the blade of an electrosurgical knife, etc., may be mounted on the tip ends of such forceps instruments.
An endoscopic surgical operation performed with forceps instruments requires the surgeon to be trained in advance, because the working space within the body cavity is small, and the forceps instruments need to be operated using the trocars as fulcrums. Since forceps instruments, which have been used heretofore, do not have joints in the working unit on the tip end thereof, such forceps instruments have a small degree of freedom, and the working unit can be operated only on an extension of the shaft. Therefore, cases that can be handled under usual training practices for endoscopic surgery are limited to a certain range, and the surgeon must be trained and possess a considerably high level of skill in order to be able to perform endoscopic surgeries on various other cases that lie outside of this limited range.
Attempts have heretofore been made to improve conventional forceps instruments and to develop a forceps instrument having a plurality of joints in a working unit thereof (see, for example, Japanese Laid-Open Patent Publication No. 2002-102248). This developed forceps instrument, which may also be referred to as a manipulator, is free of the limitations and difficulties posed by conventional forceps instruments, can be operated with easy techniques, and can be applied to a wide variety of cases. For example, it is expected that the developed forceps instrument will be applied to techniques requiring intricate manipulative actions inside of small spaces. One example of such techniques is DVC ligation, for ligating a DVC (Dorsal Vein Complex) during a prostatectomy procedure. It has been difficult to perform DVC ligation when performing endoscopic surgeries using conventional techniques and methods.